ABSTRACT The objective of the Healthcare System & Technology Design Core (`Design Core') is to adapt and extend new methods for the design, deployment and evaluation of technology-enabled services tailored for older adults with multiple chronic conditions (MCC) and their caregivers. We will translate innovative research in digital health, building to scale for sustainable implementation in diverse primary care practices. Significant enthusiasm exists for technologies to transform healthcare service delivery. It has been proposed that technologies can improve quality and reduce the cost of healthcare, increase a patient's capacity to successfully engage in treatment decision-making and self-care behaviors, improve communication with a primary care team, moving treatment outside of clinics into peoples' homes and deploy a variety of devices to help embed services into the fabric of peoples' everyday lives. Unfortunately, for all the evidence demonstrating that such technologies can work under controlled conditions, we have identified several failures of technology development and evaluation that hinder meaningful impact on healthcare services for older adults with MCC. The Design Core's goal is to spur research on the integration of technologies into healthcare services for older adults with MCC and their caregivers. Our specific aims are to: Aim 1 Provide expertise to investigators in the design, evaluation and implementation of technology-enabled services for older adults with MCC and their caregivers. Aim 2 Create a prototype technology-enabled service, designed for older adults with MCC and symptoms of anxiety or depression, to communicate more effectively with their clinicians. Aim 3 Develop and disseminate a methodology guide that summarizes best practices for applying user- centered design (UCD) to optimize technology-enabled services for older adults with MCC. The Design Core will become a national hub of expertise in the design and evaluation of technology-enabled services for older adults with MCC (Aim 1). We will extend CBITs' expertise accumulated over 8 years and 70+ projects to support the design, development, and evaluation of technology-enabled services. We will devise an MCC-specific technology design prototype through a `reference' project (Aim 2). We will then integrate our work with other leaders nationally, producing an initial guide for supporting the development of technology enabled services appropriate for primary care settings and among older adults with MCC (Aim 3).